After the end of disease: a historical perspective on epidemic narratives

In Rotary’s ad campaign a few years ago, people from Desmond Tutu to Jackie Chan were showing with their hands how close to the end of polio we are. There was even a Gangnam Style version of the ad. The message was that the end is in sight, we are very close and need just one last push to end the disease targeted by a global eradication program. The ad looks great. You stop and look, perhaps even open your purse to contribute to the cause. But at the same time it is also terribly disturbing: what are these people showing us? What is, exactly, the end of polio? And what comes after? Upon closer inspection, these images open broader questions of how we think about epidemics, disease and ‘solving’ a public health problem.

The way we tend to think about diseases, especially in policy-making and in their representations, is within a narrative that comes from epidemics. We talk about an “epidemic” of obesity, of cancer, and further health concerns “plague” our society. Therefore, while various diseases bring up a wide range of different problems to consider, it is important to give epidemics and their narratives a closer look. Using the case of polio eradication in Hungary, I interrogate the ending of an epidemic and place the ‘after’ into the center of analysis. I argue that with this analytical shift, we can gain a more nuanced understanding of what epidemics are, the how we might study them and who and what gets left out of the master narrative of beginning, crisis and end. A focus on endings also highlights the narrative’s shortcomings and the stakes at hand, as epidemic narratives shape global and local health policies.